A Non-Operative Salvage of Surgically-Resistant Pseudarthroses and Non-Unions by Pulsing Electromagnetic Fields

Bassett, C. Andrew L.; Pilla, Arthur A.; Pawluk, Robert J.

doi:10.1097/00003086-197705000-00017

Cited by 128 publications

(108 citation statements)

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“…In a case in which only small localized areas ofbone are rendered resistant to PTH action, there would likely be no significant changes in the overall circulating concentrations of calcium or PTH, leading to increased bone density in the affected areas without systemic effects on mineral balance. This in fact has been observed clinically (1,2).…”

Section: Discussionmentioning

confidence: 58%

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Effects of electromagnetic stimuli on bone and bone cells in vitro: Inhibition of responses to parathyroid hormone by low-energy low-frequency fields

Luben

Cain

Chen

et al. 1982

Proc. Natl. Acad. Sci. U.S.A.

268

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Low-energy electromagnetic fields pulsed at frequencies of 10-90 Hz significantly increase healing ofchronic fracture nonunions in man. These fields are effective at tissue current levels several orders of magnitude lower than those required for transmembrane depolarization ofnormal cells. We have examined the effects of two clinically used pulsed electromagnetic fields on cultures of the osteoblast-like mouse bone cell line MMB-1. Both fields significantly reduced cellular production of cAMP in response to parathyroid hormone and osteoclast activating factor. Neither basal nor fluoride-activated levels of adenylate cyclase were altered in membranes from cells cultured in the fields; however, the same membrane -preparations exhibited markedly inhibited responses to parathyroid hormone. The fields blocked the inhibitory effects of the hormone on collagen synthesis by MMB-1 cells. However, there was no effect on the inhibition of collagen synthesis by 1,25-dihydroxyvitamin D3, which is believed to act primarily by a nuclear, rather than by a membrane-dependent, mechanism. No significant differences were noted between effects of the two fields, one generating continuous pulse trains (72 Hz) and the other generating recurrent bursts (15 Hz) of shorter pulses. We hypothesize that these field effects are mediated primarily at the plasma membrane of osteoblasts, either by interference with hormone-receptor interactions or by blocking of receptor-cyclase coupling in the membrane. These responses occurred with induced extracellular fields of 1 mV/cm or less, even though transmembrane potential gradients are typically 105 V/cm.Clinical studies (1-5) have demonstrated the usefulness ofelectromagnetic fields in stimulatinghealing ofchronically ununited fractures in humans. Devices generating such fields have been approved for clinical use. However, the mechanisms of action of these fields are not clear. Oscillating electromagnetic fields proven effective in clinical use generate electrochemical gradients in the tissue fluid surrounding cells (6), but these gradients are considerably weaker than the levels required to depolarize cell membranes. Typically, the devices in question impose -20-G pulsed magnetic fields, which induce current densities of -1 uA/cm2 and associated electric gradients of 1-10 mV/cm in extracellular fluids (2). Because of the high resistance ofcell membranes, any transmembrane electrical components ofimposed fields would be lower than the extracellular gradients by two to three orders of magnitude (6) and thus as much as six orders of magnitude less than the typical excitatory threshold currents of 1 mA/cm2 observed for axonal depolarization (7).It would therefore appear that the effectiveness ofsuch weak stimuli in generating cellular processes must depend on a series of amplification mechanisms, either before or during the transmembrane coupling of the initial stimulus (8). Likely loci for amplification and extension of weak electrochemical triggering events at the cell membrane may involve ...

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Section: Discussionmentioning

confidence: 58%

“…Clinical studies (1)(2)(3)(4)(5) have demonstrated the usefulness ofelectromagnetic fields in stimulatinghealing ofchronically ununited fractures in humans. Devices generating such fields have been approved for clinical use.…”

mentioning

confidence: 99%

Effects of electromagnetic stimuli on bone and bone cells in vitro: Inhibition of responses to parathyroid hormone by low-energy low-frequency fields

Luben

Cain

Chen

et al. 1982

Proc. Natl. Acad. Sci. U.S.A.

268

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“…The objective of this case report was to add evidence to the cases presented in the literature and to make a review of such an interesting and challenging topic, suggesting that although used for decades (since 1977), PEFM is still a valid option, inexpensive, and without side effects (8).…”

Section: Discussionmentioning

confidence: 99%

Delayed Union of Scaphoid Fracture and Effectiveness of Pulsed Electromagnetic Fields: A Case Report and Review of the Literature

Fernández-Cuadros

Pérez-Moro

Albaladejo-Florín

et al. 2018

Middle East J Rehabil Health Stud

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Fractures of the scaphoid are the most common fractures of the carpal bones. Because of the distal perfusion of the bone, there is a great chance to present complications such as avascular necrosis, delayed union of the fracture and subsequently, early osteoarthritis (up to 32%). For those reasons, the treatment of scaphoid fractures remains a challenge. Pulsed electromagnetic fields (PEMF) have been used for decades as an alternative option in delayed bone healing fractures with good results. However, to the best of our knowledge, there are scarce reports, if any, on scaphoid fractures. The objective of this case report was to show delayed union fracture as a common complication of scaphoid fracture and to postulate PEMF as an effective treatment option for such a condition, reflected by our clinical and radiological evaluations and supported by a thorough review of the literature. The patient received 20 sessions of PEMF, using the QS Magneto therapy device ® , with a dose of 20Hz-50Gauss-20 minutes, 5 times a week for 4 weeks.PEMF could recover delayed nonunion of scaphoid fracture and decreased pain as evaluated clinically and radiologically in our case report.

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“…Several techniques for electrical stimulation, using either direct current (Brighton et al 1977, Paterson et al 1980 or pulsing electromagnetic fields (Bassett et al 1977), are commercially available today. None of these systems has, to our knowledge, been shown to be more effective than any other.…”

Section: Torbjornmentioning

confidence: 99%

Electrical treatment of non-united fractures

Ahl

Andersson

Herberts³

et al. 1984

Acta Orthopaedica Scandinavica

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A Non-Operative Salvage of Surgically-Resistant Pseudarthroses and Non-Unions by Pulsing Electromagnetic Fields

Cited by 128 publications

References 0 publications

Effects of electromagnetic stimuli on bone and bone cells in vitro: Inhibition of responses to parathyroid hormone by low-energy low-frequency fields

Effects of electromagnetic stimuli on bone and bone cells in vitro: Inhibition of responses to parathyroid hormone by low-energy low-frequency fields

Delayed Union of Scaphoid Fracture and Effectiveness of Pulsed Electromagnetic Fields: A Case Report and Review of the Literature

Electrical treatment of non-united fractures

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